HomeMy WebLinkAbout1994-006057 - deck � PERMIT
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway • P.O. Box 815 ��`_k�.�.�:i 1��v;;
Orono, Minnesota 55356-0815 Permit Number: 1_.::=€_�.:t,_�,,
(612) 473-7357 . Date Issued: _ - _. ,
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SITE ADDRESS:
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DESCRIPTION:
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CONTRACTOR: OWNER: - �:.:F�E.,: ����;�;:=:. --
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APPLICANT/PERMITEE SIGNATURE . ISSUED BY:SIGNATURE ���
' � CITY OF ORONO - BIIIZDING PEFtMIT APPLICATION
Total Fee: $ �f1.�
Date Received: � � � y `�
Date Approved:
Entered By: ��'�r - Permit�: (�-C��`7
AI�L INFORMATION MIIST B$ SIIBMITTSD IN FIILL BEFORE PLAN REVIEW WILL Bg STAR�ED
(See Check-off List Enclosed)
--------------------------------------------------------------------------------
Z'HE APPLICANT IS: (circle one) WNER or CONTRACTOR
Jos ss� x�Dx$ss: 13�� � �o � �, �l . S� . , wq.�, ��0. zzP: 5 S 3 q I
(work)�� ��� 8�
N�L OF OWNER- , � I 'e PHONE: (hoine) �,�^ y7?�
Z■iAILING ADDRESS: SD CITY: �it�a-.� `zu�['4 ZIP: SS 3 !�_
�ONTRACTOR: PHON$:
MASLING ADDRESS: CITY: ZIP:
STATS LICENSE: �
ARCHITECT/ENGINEER: PHONE:
1+tATLING ADDRSSS: CITY: ZIP:
1YAI�: RBGISTRATION �
TYPE OF WORR: New Addition Accessory Structure Move
Demo Remodel/Alteration Renovate Land Alteration
PROPOSF.D WORK (describe in detail) : a-d� � � i o v� 0 7� �2 �� q� V��-f� � �
-�c� �t 5 �2
STORIES: SQ. FEBT OF EACH FLOOR:
NO. OF BBDROOMS: GARAGB ST�I.LS: ATT. DET.
ESTIMATED CONSTRIICTION VALIIATION (eacluding la.nd) : $ � �0 � D D
I hereby apply for a building permit and I acknowledge that the information
above is complete and accurate; that the work will be in conformance with the
erdinances and codes of the City and with the State Building Code; that I
understand this is not a permit and work is not to start without a permit; and
that the work wil 1 be in accordance with the approved plan.
APPLICANT'S SIGNAZ'URE: ^ A DATE: � " d'� ' I �
�
CITY of ORONO
Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Officea
•
� - � � On the North Shore of Lake Minnetonka
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd. 2, "Rights of subjects of
data", we would Iike to inform you that your request for a permit or
license from the City of Orono or any of its departments may require
you to furnish certain private or confidential. information.
You are notified that:
1. The information you furnish will be used to determine your
qualification for the permit or Iicense requested.
2. You may refuse to supply data, but refusal may require that
the City deny the permit or Iicense.
3. The information may be shared with other iocal , state or
federal agencies to the extent necessary to process the permit or
Iicense.
4. If your requested permit or Iicense requires Councii. action
to approve, some information may become public.
5. You have certain rights under M.S. 13.04 to review priva�c
data on yourself.
6. Yaur full name is required to process this applicatian or
permit.
� � I �
` ` �r � �
First Middle Last
� �� 5�' (� �- o w � � � S �
Ad ress
� � z�� �,,,� n�� 5�S 3 � 1
Ci� State Zip
h� 7 �. _ �I 7 �7 �
Phone
I understand my rights as stated above.
� c �
Signature
BUILDING&ZONING-473-7357 • ADMINISTRATION&FINANCE-473-7358 • PUBLIC WORKS-473-7359
ASSESSING
�,04 RIGHTS OF SIIBJF.cTS OF DATA
Subdivision L Type cf data- The rights of individuals on whom the data is
stored or to be stored shall be as set forth in this section.
Subd. 2. Information required to be g��� ����1" An.individual esked to
� supply private or confidential data concernindg �aTnW hin the collecti g state agency,
purpose and intended use of the requested
(b) whether he ma� refuse or is legally
political subdivision, or statewide syste�c� 8ny �own consequence arising from his
required to supply the requested date;
supplying or refusing to supply private or confidential data; and (d) the identity o
other persons or entities authorized by state or federal law to receive the data. This_
1 when en individual is asked to supply investigative data,
requirement shall not app y
pursuant to section 13.82, subdivision 5, to a law enforcement officer.
The commissioner of revenue ma role�t taX re°und instructeonsui steadhos
subdivision in the individual income tax •r
on those orms. . --- -
Subd. 3. Access to �ata by individual• Upon request to e responsible "
authority, an individuel shall be informed whether h��gteeor confident al.e Upon his
individuals; and whether it is classified as public, p ublic date on
further request, an individusl raiho is the subject of Se to himrlande if he desires, shall
individu$ls shall be shown the data withou�fan�y ��ta. After an individual hes been
6e informed of the content and meaning the data need not be �sclosed to
shown the private data and informed of its meaning� u�uant to this section is
him for six months thereafter unless e dispute or action p
, � pending or additional data on the indiv�if�h h� gteeor public datarupon request by
responsible authority shall provide copies P
the individual subject of the �ta• � of msking,lcert fyingyand c mpiling the
requesting person to pay the actual cos
copies. ssible, with any request
The responsible authority shall comply immediately, if po
made pursuant to this subdivision, or �tholide e,�f Simmediategtc mpliance eisu not
excluding Saturdays, Sundays and leg YS
possible. If he cannot comply with the request within that time, he shall so in�or h the
individual, and may hsve sn additional five days within which to comply
request, excluding Saturdays, SundaYS and legal holidays•
Subd. 4. Proced�e when data is not ecciu�ate or complete. An individugl may
contest the accuracy or completeness of public or private dat�he°res onsib e au hor ty
exercise this right, an individual shall notify in writing P
describing the nature of the disagreem tp beTnaccurpa e or incomplete and att pt to
days either: (a? correct the data found
notify past recipients of inaccurate or in�u�P�t hea believesdthe datalto be correct
the individuel; or {b) notify the indivi
Data in dispute shall be disclosed only if the individuel's statement of disagreement �s
• included with the disclosed data. � 8�pe�e� P�u�t to the
' The determination of the responsible authority may
provisions of the administrative procedure act relating to contested cases.
CHECR OFF LIST FOR ISSIIANCE OF PERMITS
FOR OFFICE USE ONLY
ADDR$SS OR LEGAL: I 3�f 5 f3 f��.� ��%�-,'� PID:
DESGRIPTION OF WORR: i� c=�cC � C�55 '�tr✓ �� �� i1Jo G�4�/!�/Is��L (ivoN L�tic/ce,�� s
----------------------------------------------------_------5-------------------i
ZONING REVIEW BY: �� ,,�,._ DATE APPROVF�D ,� `I `�
BIIILDING REVIEW BY: DATS APPROVED: j -�� � � �'r
---------------
F�S TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes �'�'�No
PLAN REVIEW Yes ii No SEWER CONNECTION
STATE SURCHARGE Yes �' No WATER CONNECTION
INVESTIGATION FEE Yes No v'"� PARK FEE
SAC Yes No `''"�r SITE INSPECTION
Number of SAC Units OTHER (specify)
------------------------------------------------------------
ZONING CHECR LIST Zoning District: f)� �t�
Fire Department: Post Office: __:� � Sei��vol District:
i/ �, (-
' � �`H2 t�i t
Lot Area: Width� , � P
Survey Submitted: Ye s��C No Date I�of Survey: ��-"�- �s
� o,� t�c�-
Proposed Setbacks : -
Front (Lake) : �c�} � J Right Side: �5��+ �
Rear (Street) : �c� �(w� Lef t Side: �� + S
�
Ad j acent Structures: ���-x���-�c� Wetland: � ��
BuiJ.ding Height: Def. Hgt. /t/(� Peak Hgt.
Avg. Setback• %�/ ��-1 Lot Coverage:7 S l�
Existing Proposed
Hardcover: 0-75 '
75-250 '
250-500 '
500-1000 ' _ � .�. 5 ��
Hardcover Variance Required: Yes Noi� Date of Cot�cil Approval:
I �
Grading: Staff Appr�val Date: By: ' Counci� Approval Date:
Septi c: Staf f Apprav ]. Date: By:
Zoning Fi�e:# Resolution #: Resolution Date:
RF.MARKS (in house) : ���C�(= �� C.PSS;' ��� 3U " C.�r�-r ��� �. ���?�f� ��-
� �
`�y vr/ �j ��s r r�—z�-�=�� f� fu oN c-rJC:��vr'n""`�- ��� yl� ��1 v�2c.�-,-.�✓ 5
�
��C� S�G�O/� IU.D:�� ��.3✓> ls L�� �
BQII�DING REVIEW CHECK LIST . .
�gC: � ��- � CONSTRIICTION TYPE: ���'�
Sq Footage $ Per Sq Ftg
Basement X - -
lst Fl.00r X -
2nd Fl.00r X -
G�age -- -
' � Cr 1� (�_c� o , /�� G�,�H2i�� ��� —
` �$rc.
TOTAL
Estimated Construction Val�ue: $ 2, ,LL �v
Inspections Required: Work Requiring Separate Permits:
Site � Plumbing Grading/Fil.�ing
�Footing Mechanical Fire
Framing Septic Water Connection
Insulation Fireplace Sewer Connection
Wa�l Board (Masonry) Lawn Irrigation
Final (Mfg.) Other
�Other Wel]� (State Permit)
Electrical (State Permit)
------------------------------------------------
REMARRS (IN HOIISE) :
---------------------------------------------------
REVIEW BY OTHERS: DATE:
Access : Existing New
Access ApprovaJ�: Date BY=
----------------------------------------------
RF.MARRS (TO BE NOTED ON PERMIT) :
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_� �_�___� _. i ; ; ; . _ . _ I`�.-/4i'J� C�c3 (
� : ) : .
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTI SCHEDUIED
PERMIT N0. ��LS COMPLETED
ADDRESS � ���"� �
OWNER CONTR.
.
TELEPHONE NO.
� DESCRIPTION �-- '
LL 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
05 FI 14 SEWER HOOK-UP 06 PROGRESS
� 7 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
? 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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d ❑WORKSATISFACTORY:PROCEED Vf.PROJECTCOMPI.ETE
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� C CORRECT WORK&PROCEED (i' SSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR '= CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next in pection 24 hours in advance.473-7357
OwnerlContr to o i
Inspector.
White Copyllnspe �'s-Ft Canary Copy/Site Notice